A+ A A-

Download article


Radkevich A.A., Zykova O.S.
Psoriasis and periodontitis: immune-mediated inflammatory diseases interdependency
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2020;19(6):105-114.

Psoriasis is a chronic inflammatory ailment with a predominantly immune dysregulation in its pathogenesis. Being a classical proliferative dermatosis, psoriasis may be complicated with nail plate and joint lesions. Topographic abundance of lesions is a sign of a systemic disease. Periodontitis is also a chronic inflammatory process that affects the periodontal ligament, gingiva and alveolar bone. Periodontal diseases are initiated by periodontopathogenic microorganisms that are accumulated in a bacterial biofilm on the tooth surface. Periodontopathogenic microorganisms may be found on the patients’ teeth with no evidence of periodontal damage. The relationships between the biofilm and host immune response are dynamic. The composition of microbiota is influenced by a number of local factors, however systemic factors may also have a significant effect.
Association between immune-mediated systemic inflammatory diseases and periodontal diseases has been actively studied in recent years. There is a hypothesis that systemic inflammatory diseases with exaggerated immune response may cause an inflammation in the periodontium. Some systemic diseases are considered to be able to modulate the inflammation of periodontal tissues by activation of osteoclasts via cytokines. It leads to early loss of the alveolar bone.
The status of the of oral cavity organs health of patients suffering from psoriasis is still poorly understood. The aim of the paper is to analyse the data that point out to the presence of possible association between psoriasis and periodontitis.
Key words: psoriasis, periodontitis, immune response, interleukins.


1. Perera GK, Di Meglio P, Nestle FO. Psoriasis. Annu Rev Pathol. 2012;7:385-422. doi:
2. Schon MP, Boehncke WH. Medical progress – Psoriasis. N Engl J Med. 2005;352:1899-912. doi:
3. Gelfand JM, Weinstein R, Porter SB, Neimann AL, Berlin JA, Margolis DJ. Prevalence and treatment of psoriasis in the United Kingdom: A population-based study. Arch Dermatol. 2005 Dec;141(12):1537-41. doi:
4. Parisi R, Rutter MK, Lunt M, Young HS, Symmons DPM, Griffiths CEM, et al. Psoriasis and the Risk of Major Cardiovascular Events: Cohort Study Using the Clinical Practice Research Datalink. J Invest Dermatol. 2015 Sep;135(9):2189-2197. doi:
5. Ding X, Wang T, Shen Y, Wang X, Zhou C, Tian S, et al. Prevalence of psoriasis in China: A population-based study in six cities. Eur J Dermatol. 2012 Sep-Oct;22(5):663-7. doi:
6. Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014 Mar;70(3):512-6. doi:
7. Griffiths CE, Barker JN. Psoriasis 1 - Pathogenesis and clinical features of psoriasis. Lancet. 2007 Jul;370(9583):263-271. doi:
8. Mrowietz U, van de Kerkhof PCM. Management of palmoplantar pustulosis: do we need to change? Br J Dermatol. 2011 May;164(5):942-6. doi:
9. Baran R. The Burden of Nail Psoriasis: An Introduction. Dermatology. 2010;221 Suppl 1:1-5. doi:
10. Kunder EV, Zykova OS. Psoriasis and psoriatic arthritis. Minsk, RB: BelMAPO; 2018. 248 р. (In Russ.)
11. Korotaeva TV, Samtcov AV, Bakulev AL, Kokhan MM, Minullin IK, Vylegzhanina OA, i dr. Comparative efficacy and safety of biosimilar adalimumab (BCD-057) and original adalimumab in patients with psoriasis vulgaris.  Results of BCD-057-2 / CALYPS0 - Phase III International Multicenter, Randomized, Double-Blind Clinical Study. Sovremen Revmatologiia. 2018;12(4):71-84. (In Russ.)
12. Ellis CN, Gorsulowsky DC, Hamilton TA, Billings JK, Brown MD, Headington JT, et al. Cyclosporine improves psoriasis in a double blind study. JAMA. 1986 Dec;256(22):3110-6.
13. Griffiths CE, Powles AV, Leonard JN, Fry L, Baker BS, Valdimarsson H. Clearance of psoriasis with low dose cyclosporine. Br Med J (Clin Res Ed). 1986 Sep;293(6549):731-2. doi:
14. Kunder EV, Litviakov AM, Zykova OS, Generalov II, Volkova MV. Catalytic activity of IgG in isolated cutaneous psoriasis, psoriatic onychodystrophy and arthropathic psoriasis. Vestn VGMU. 2007;6(2):56-61. (In Russ.)
15. Fry L, Baker BS, Powles AV, Fahlen A, Engstrand L. Is chronic plaque psorias is triggered by microbiota in the skin? Br J Dermatol. 2013 Jul;169(1):47-52. doi:
16. Matusiewicz D, Koerber A, Schadendorf D, Wasem J, Neumann A. Childhood psoriasis – an analysis of German health insurance data. Pediatr Dermatol. 2014 Jan-Feb;31(1):8-13. doi:
17. Yang YW, Keller JJ, Lin HC. Medical comorbidity associated with psoriasis in adults: a population-based study. Br J Dermatol. 2011 Nov;165(5):1037-43. doi:
18. Lӧe H, Anerud A, Boysen H, Morrison E. Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan labourers 14 to 46 years of age. J Clin Periodontol. 1986 May;13(5):431-45. doi:
19. Van Dyke TE. The management of inflammation in periodontal disease. J Periodontol. 2008 Aug;79(8 Suppl):1601-8. doi:
20. Walker C, Sedlacek MJ. An in vitro biofilm model of subgingival plaque. Oral Microbiol Immunol. 2007 Jun;22(3):152-61. doi:
21. Socransky SS, Haffajee A, Cugini M, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998 Feb;25(2):134-44. doi:
22. Milward MR, Chapple IL, Carter K, Matthews JB, Cooper PR. Micronutrient modulation of NF-κB in oral keratinocytes exposed to periodontal bacteria. Innate Immun. 2013;19(2):140-51. doi:
23. Theilade E. The non-specific theory in microbial etiology of inflammatory periodontal diseases. J Clin Periodontol. 1986 Nov;13(10):905-11. doi:
24. Haffajee AD, Socransky SS, Smith C, Dibart S. Microbial risk indicators for periodontal attachment loss. J Periodontal Res. 1991 May;26(3 Pt 2):293-6. doi:
25. Preshaw PM, Taylor JJ. How has research into cytokine interactions and their role in driving immune responses impacted on our understanding of periodontitis? J Clin Periodontol. 2011 Mar;38 Suppl 11:60-84. doi:
26. Lerner UH. Inflammation-induced bone remodeling in periodontal disease and the influence of post-menopausal osteoporosis. J Dent Res. 2006 Jul;85(7):596-607. doi:
27. Shi Q, Zhang B, Xing H, Yang S, Xu J, Liu H. Patients with Chronic Obstructive Pulmonary Disease Suffer from Worse Periodontal Health – Evidence from a Meta-Analysis. Front Physiol. 2018 Jan;9:33. doi:
28. Deschamps-Lenhardt S, Martin-Cabezas R, Hannedouche T, Huck O. Association between periodontitis and chronic kidney disease: Systematic review and meta-analysis. Oral Dis. 2019 Mar;25(2):385-402. doi:
29. Leech MT, Bartold PM. The association between rheumatoid arthritis and periodontitis. Best Pract Res Clin Rheumatol. 2015 Apr;29(2):189-201. doi:
30. Keller JJ, Lin HC. The effects of chronic periodontitis and its treatment on the subsequent risk of psoriasis. Br J Dermatol. 2012 Dec;167(6):1338-44. doi:
31. Egeberg A, Mallbris L, Gislason G, Hansen PR, Mrowietz U. Risk of periodontitis in patients with psoriasis and psoriatic arthritis. J Eur Acad Dermatol Venereol. 2017 Feb;31(2):288-293. doi:
32. Méndez GL, Solis L, Rodríguez C, Chila-Moreno L, Buenahora MR, Delgadillo N, et al. Psoriasis Vulgaris: Relationship between Oral and Periodontal Conditions and Disease Severity. Open Dermatol J. 2019;13:47-54. doi:
33. Guo B. IL-10 Modulates Th17 Pathogenicity during Autoimmune Diseases. J Clin Cell Immunol. 2016 Apr;7(2):400. doi:
34. McGeachy MJ, Bak-Jensen K S, Chen Y, Tato CM, Blumenschein W, McClanahan T, et al. TGF-beta and IL-6 drive the production of IL-17 and IL-10 by T cells and restrain T(H)-17 cell-mediated pathology. Nat Immunol. 2007 Dec;8(12):1390-7. doi:
35. Zenobia C, Hajishengallis G. Basic biology and role of interleukin-17 in immunity and inflammation. Periodontol 2000. 2015 Oct;69(1):142-59. doi:
36. Mitra A, Raychaudhuri SK, Raychaudhuri SP. IL-17 and IL-17R: An auspicious therapeutic target for psoriatic disease. Actas Dermosifiliogr. 2014 Oct;105 Suppl 1:21-33. doi:
37. Abusleme L, Moutsopoulos NM. IL-17: Overview and role in oral immunity and microbiome. Oral Dis. 2017 Oct;23(7):854-865. doi:
38. Dutzan N, Abusleme L, Bridgeman H, Greenwell-Wild T, Zangerle-Murray T, Fife ME, et al. On-going Mechanical Damage from Mastication Drives Homeostatic Th17 Cell Responses at the Oral Barrier. Immunity. 2017 Jan;46(1):133-147. doi:
39. Yu JJ, Ruddy MJ, Wong GC, Sfintescu C, Baker PJ, Smith JB, et al. An essential role for IL-17 in preventing pathogen-initiated bone destruction: Recruitment of neutrophils to inflamed bone requires IL-17 receptor-dependent signals. Blood. 2007 May;109(9):3794-802. doi:
40. Veldhoen M. Interleukin 17 is a chief orchestrator of immunity. Nat Immunol. 2017 May;18(6):612-621. doi:
41. Vernal R, Dutzan N, Chaparro A, Puente J, Valenzuela MA, Gamonal J. Levels of interleukin-17 in gingival crevicular fluid and in supernatants of cellular cultures of gingival tissue from patients with chronic periodontitis. J Clin Periodontol. 2005 Apr;32(4):383-9. doi:
42. Schenkein HA, Koertge TE, Brooks CN, Sabatini R, Purkall DE, Tew JG. IL-17 in sera from patients with aggressive periodontitis. J Dent Res. 2010 Sep;89(9):943-7. doi:
43. Raychaudhuri SK, Saxena A, Raychaudhuri SP. Role of IL-17 in the pathogenesis of psoriatic arthritis and axial spondyloarthritis. Clin Rheumatol. 2015 Jun;34(6):1019-23. doi:
44. Ekman A-K, Eding CB, Rundquist I, Enerbäck C. IL-17 and IL-22 promote keratinocyte stemness in the germinative compartment in psoriasis. J Invest Dermatol. 2019 Jul;139(7):1564-1573. doi:
45. Tan Y, Qi Q, Lu C, Niu X, Bai Y, Jiang C, et al. Cytokine Imbalance as a Common Mechanism in Both Psoriasis and Rheumatoid Arthritis. Mediators Inflamm. 2017;2017:2405291. doi:
46. Chabaud M, Fossiez F, Taupin JL, Miossec P. Enhancing effect of IL-17 on IL-1-induced IL-6 and leukemia inhibitory factor production by rheumatoid arthritis synoviocytes and its regulation by Th2 cytokines. J Immunol. 1998 Jul;161(1):409-14.
47. Beklen A, Ainola M, Hukkanen M, Gürgan C, Sorsa T, Konttinen YT. MMPs, IL-1, and TNF are regulated by IL-17 in periodontitis. J Dent Res. 2007 Apr;86(4):347-51. doi:
48. Dutzan N, Gamonal J, Silva A, Sanz M, Vernal R. Over-expression of forkhead box P3 and its association with receptor activator of nuclear factor-kappa B ligand, interleukin (IL)-17, IL-10 and transforming growth factor-beta during the progression of chronic periodontitis. J Clin Periodontol. 2009 May;36(5):396-403. doi:
49. Lin D, Li L, Sun Y, Wang W, Wang X, Ye Y, et al. IL-17 regulates the expressions of RANKL and OPG in human periodontal ligament cells via TRAF6/TBK1-JNK/NF-kappaB pathways. Immunology. 2014 Sep;144(3):472-485. doi:
50. Wang M, Tian T, Yu S, He N, Ma D. Th17 and Treg cells in bone related diseases. Clin Dev Immunol. 2013;2013:203705. doi:

Information about authors:
Radkevich A.A. – senior lecturer of the Chair of General Dentistry with the course of Prosthetic Dentistry and the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
Zykova O.S. – Candidate of Medical Sciences, associate professor of the Chair of Dermatovenerology, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of General Dentistry with the course of Prosthetic Dentistry and the course of the Faculty for Advanced Training & Retraining. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Alexander A. Radkevich.

Поиск по сайту